Journal Article

Social and economic costs and health-related quality of life in stroke survivors in the Canary Islands, Spain

Perestelo Perez, Lilisbeth, Serrano-Aguilar, Pedro, Worbes Cerezo, Melany, Montón-Álvarez, Fernando, Lopez-Bastida, Julio, Oliva Moreno, Juan

2012

Overview

Background Cost-of-illness analysis is the main method of providing an overall vision of the economic impact of a disease. Such studies have been used to set priorities for healthcare policies and inform resource allocation. The aim of this study was to determine the economic burden and health-related quality of life (HRQOL) in the first, second and third years after surviving a stroke in the Canary Islands, Spain. Methods Cross-sectional, retrospective study of 448 patients with stroke based on ICD 9 discharge codes, who received outpatient care at five hospitals. The study was approved by the Research Ethics Committee of Nuestra Señora de la Candelaria University Hospital. Data on demographic characteristics, health resource utilization, informal care, labor productivity losses and HRQOL were collected from the hospital admissions databases and questionnaires completed by stroke patients or their caregivers. Labor productivity losses were calculated from physical units and converted into monetary units with a human capital-based method. HRQOL was measured with the EuroQol EQ-5D questionnaire. Healthcare costs, productivity losses and informal care costs were analyzed with log-normal, probit and ordered probit multivariate models. Results The average cost for each stroke survivor was €17 618 in the first, €14 453 in the second and €12 924 in the third year after the stroke; the reference year for unit prices was 2004. The largest expenditures in the first year were informal care and hospitalizations; in the second and third years the main costs were for informal care, productivity losses and medication. Mean EQ-5D index scores for stroke survivors were 0.50 for the first, 0.47 for the second and 0.46 for the third year, and mean EQ-5D visual analog scale scores were 56, 52 and 55, respectively. Conclusions The main strengths of this study lie in our bottom-up-approach to costing, and in the evaluation of stroke survivors from a broad perspective (societal costs) in the first, second and third years after surviving the stroke. This type of analysis is rare in the Spanish context. We conclude that stroke incurs considerable societal costs among survivors to three years and there is substantial deterioration in HRQOL.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Aged / Analysis / Caregivers / Caregivers - psychology / Caregivers - statistics & numerical data / Chronic illnesses / Cost of Illness / Cross-Sectional Studies / Disability / Disease / Economic aspects / Female / Health Administration / Health aspects / Health care costs / Health Care Costs - statistics & numerical data / Health care expenditures / Health Expenditures / Health Informatics / Health services / Health Status Indicators / Health-related quality of life / Hospitals / Humans / Informal care / Information sources / International Classification of Diseases / Islands / Labor productivity / Life expectancy / Loss of labor productivity / Male / Medical care, Cost of / Medical research / Medicine / Medicine & Public Health / Medicine, Experimental / Middle Aged / Mortality / Nursing Research / Orthopedic apparatus / Pain Measurement / Patient admissions / Prescription drugs / Public Health / Quality of Life / Questionnaires / Rehabilitation / Research Article / Retrospective Studies / Social aspects / Social Conditions / Spain / Stroke / Stroke - economics / Stroke - physiopathology / Stroke patients / Surveys and Questionnaires / Survivors - psychology / Survivors - statistics & numerical data